Long Island appears to be in good shape to implement the federal Affordable Care Act despite the state's "rough road to health reform," concluded a national report.

The state health benefit exchange, a marketplace for health insurance plans for uninsured individuals and business owners with fewer than 50 employees, is set to open for enrollment on Oct. 1 as part of the federal Affordable...

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Long Island appears to be in good shape to implement the federal Affordable Care Act despite the state's "rough road to health reform," concluded a national report.

The state health benefit exchange, a marketplace for health insurance plans for uninsured individuals and business owners with fewer than 50 employees, is set to open for enrollment on Oct. 1 as part of the federal Affordable Care Act.

The nonpartisan Center for Studying Health System Change in Washington, D.C., said in its report released Sept. 19 that "at first glance, New York and the Long Island metropolitan area appear well positioned for smooth implementation" of the federal health care overhaul.

But the report, titled "Long Island Follows Bumpy New York Road to National Health Reform," warned that the area could face problems. For one, it said, New York didn't establish its exchange until later -- April 2012 -- because of "partisan gridlock."

"The result was that the exchange got off to a late start and had less legitimacy in the eyes of some stakeholders," the report said.

And the state's "stringent insurance regulations" are tougher than federal requirements, which in the past has meant higher costs, the report said.

In Nassau, nine health insurers are offering health insurance for individuals on the exchange; in Suffolk, eight. Three insurers are offering insurance for small businesses in both counties. More insurers participated than experts expected, and the approved rates are lower than anticipated. But, the report said, "what remains uncertain is how sustainable these rates will be over time."

The study's lead author, Ha Tu, said Long Island -- one of eight areas around the country the center is examining -- was chosen because it was the largest metropolitan area outside of New York City in the state -- a too "difficult and complex market" to examine, she said.

Tu said that, despite caveats, she was hopeful about implementation of the exchange.

"I know we sounded a cautionary note in our report, but really, the first round of the exchange on Long Island has been very promising," she said.

The 13-page report, funded by the Robert Wood Johnson Foundation, looked at the Island's market and demographics. Among the wealthiest areas in the state, with an educated, healthy population, Long Island already has "high rates of private insurance coverage," the report said. Of Long Island's 2.8 million residents, about 150,000 are expected to sign on to the exchange.

Smoothing the bumps

But tight state regulation and consolidation of health plans have limited competition in the past. And the insurance market for individuals has been "minuscule and dysfunctional" -- and very expensive, the report said. The fact that hospitals are largely concentrated into several large systems has also contributed to the region's high costs, the report said.

Janine Logan, spokeswoman for the Nassau Suffolk Hospital Council, the lead agency on Long Island appointed by the state to help people navigate the exchange, took issue with the "bumpy road" description in the report's title.